title: Advances in intrathecal drug delivery.
abstract: OBJECTIVE
  Targeted intrathecal drug delivery systems (IDDS) are an option in algorithms for the treatment of patients with moderate-to-severe chronic refractory pain. This article is intended to review the literature regarding IDDS published over the last year, with special attention to the Polyanalgesic Consensus Conference 2012.
  
  
  RESULTS
  The recommendations made by the Polyanalgesic Consensus Conference 2012 are reviewed. Separate considerations of intrathecal drug therapy for neuropathic and nociceptive pain syndromes and the new concept of 'microdosing' are discussed in this article.
  
  
  CONCLUSIONS
  This review includes the recommendations for the use of IDDS, trialing, and recent reports of complications (especially, the occurrence of granulomas). In addition, the latest documents on cerebrospinal fluid and potential lines of future development are discussed.
authors.affiliation: aDepartment of Surgical Specialties, Anesthesia Division, Valencia University Medical School bAnesthesia Department cMultidisciplinary Pain Management Department, Valencia General University Hospital, Valencia, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: De Andres
authors.forename: Juan M
authors.initials: JM
authors.lastname: Asensio-Samper
authors.forename: Gustavo
authors.initials: G
authors.lastname: Fabregat-Cid
mesh_terms: D059350:Chronic Pain / Q000188:drug therapy*; D016503:Drug Delivery Systems; D006801:Humans; D007278:Injections, Spinal / Q000009:adverse effects; D009369:Neoplasms / Q000503:physiopathology; D009437:Neuralgia / Q000188:drug therapy*; D010148:Intractable Pain / Q000188:drug therapy*